Radiation-induced optic neuropathy: A magnetic resonance imaging study

J. Guy, A. Mancuso, R. Beck, M. L. Moster, L. A. Sedwick, R. G. Quisling, A. L. Rhoton, E. E. Protzko, J. Schiffman

Research output: Contribution to journalArticle

69 Scopus citations

Abstract

Optic neuropathy induced by radiation is an infrequent cause of delayed visual loss that may at times be difficult to differentiate from compression of the visual pathways by recurrent neoplasm. The authors describe six patients with this disorder who experienced loss of vision 6 to 36 months after neurological surgery and radiation therapy. Of the six patients in the series, two had a pituitary adenoma and one each had a metastatic melanoma, multiple myeloma, craniopharyngioma, and lymphoepithelioma. Visual acuity in the affected eyes ranged from 20/25 to no light perception. Magnetic resonance (MR) imaging showed sellar and parasellar recurrence of both pituitary adenomas, but the intrinsic lesions of the optic nerves and optic chiasm induced by radiation were enhanced after gadolinium-diethylenetriaminepenta-acetic acid (DTPA) administration and were clearly distinguishable from the suprasellar compression of tumor. Repeated MR imaging showed spontaneous resolution of gadolinium-DTPA enhancement of the optic nerve in a patient who was initially suspected of harboring recurrence of a metastatic malignant melanoma as the cause of visual loss. The authors found the presumptive diagnosis of radiation-induced optic neuropathy facilitated by MR imaging with gadolinium-DTPA. This neuro-imaging procedure may help avert exploratory surgery in some patients with recurrent neoplasm in whom the etiology of visual loss is uncertain.

Original languageEnglish (US)
Pages (from-to)426-432
Number of pages7
JournalJournal of neurosurgery
Volume74
Issue number3
DOIs
StatePublished - Jan 1 1991
Externally publishedYes

Keywords

  • Gadolinium-DTPA
  • Magnetic resonance imaging
  • Neuropathy
  • Optic nerve
  • Radiation necrosis

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

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  • Cite this

    Guy, J., Mancuso, A., Beck, R., Moster, M. L., Sedwick, L. A., Quisling, R. G., Rhoton, A. L., Protzko, E. E., & Schiffman, J. (1991). Radiation-induced optic neuropathy: A magnetic resonance imaging study. Journal of neurosurgery, 74(3), 426-432. https://doi.org/10.3171/jns.1991.74.3.0426